Tuesday, June 24, 2014

Every so often, it’s worth taking a look at how badly we’ve
allowed ourselves to distort reality. We generally think that health care costs
in the U.S. are about what they are in the rest of the world, or maybe just a
bit worse. We seldom allow ourselves to see the true state of affairs.
Accordingly, when a wake-up call comes along like the recent announcement from
the Commonwealth Fund:http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror?omnicid=EALERT495214&mid=mh@cmwf.org--we either don’t know what to do with it at all, or quickly
look for someplace to hide.

A while ago, I was glancing at a talk given by Michael Fine,
head of public health in Rhode Island. He made the interesting point that
health care in the U.S., calculated on a per capita basis, costs more than it
does in the United Kingdom and Japan.
Let me be very clear about this: The average annual cost of health care, per
person, in the UK, plus the average annual cost of health care, per person, in
Japan, is less than the cost of health care, per person, in the U.S.

Maybe a few Americans have an idea that health care costs
more in the U.S. than elsewhere, and that we actually get less for what we
spend here than elsewhere. But I rather doubt that most Americans realize just
how bad it is—that people in two other advanced nations of the
world pay as much as we do per person (actually, not quite so much) for health
care.

I was reminded of these figures thanks to the Commonwealth
Fund’s handy reminder. They don’t include Japan in their list of 11 countries,
but they give several other examples. You can assemble the figures for “almost
as much as the U.S. spends on health per person per year” in several different
ways:

The U.K. or Sweden
or New Zealand or Australia

Plus

Canada or France or Germany

Either approach would come in less than the U.S., which tops
all of the countries at $8508 per person per year. The next highest country is
Norway, far back at $5669. (The first batch of countries I picked all spend
between $3000 and 4000 per person per year; the second set spend between $4000
and $5000.)

The remainder of the report is not terribly auspicious for
the U.S. America often spends the most money and gets the worst results. A few
areas show some modest improvement since the last time the people looked, but
generally things are down in the cellar and mostly staying there.

For many decades we have been used to hearing that the U.S.
has “the best health care system in the world.” This has pretty much gone by
the boards, though we’ll still find some dumb politico repeating it
occasionally. But how far we have sunk from that status is not seen clearly by
the vast majority of citizens.

Pharmaceutical costs play a relatively small
role in the excessive costs of U.S. health care, making up only about 10
percent of American total health care costs. But the average American has no
idea whatsoever of how incredibly pricey American health care is, compared to
any other country.